Ethnic Differences in Presentation and Severity of Alcoholic Liver Disease
Ethnic Differences in Presentation and Severity of Alcoholic Liver Disease
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DOI：
10.1111/acer.12660
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发表时间：
2015-03-01
影响因子：
3.2
通讯作者：
Medici, Valentina
中科院分区：
文献类型：
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作者：
Levy, Robert E.;Catana, Andreea M.;Medici, Valentina
酒精性肝病(ALD)的发生率因种族而异，包括酒精性脂肪变性、肝炎和肝硬变。方法为了评估种族在确定酒精性肝病发病年龄和严重程度中的作用，并比较不同种族之间酒精性肝病进展的危险因素，我们对2002-2010年间在加州大学戴维斯医学中心住院或随访的所有酒精性肝病患者进行了回顾性图表回顾。在排除了HBs Ag和HIV阳性的受试者后，我们回顾了791例ALD患者的图表，其中包括130例酒精性脂肪肝，154例酒精性肝炎和507例酒精性肝硬变。结果在控制模型中的所有变量后，在3种疾病严重程度类别中，西班牙裔患者明显比白人/高加索患者年轻4-10岁，并且在排除丙型肝炎抗体/RNA阳性受试者后，结果得到证实。在患有酒精性肝炎的非裔美国人中，西班牙裔肥胖患者的比例明显高于白人/白人患者，而在患有酒精性肝炎的非裔美国人中，丙型肝炎患者的比例明显高于白人/白人患者，而糖尿病患者的比例在白人/白人患者中显著低于西班牙裔肝硬化患者。在西班牙裔和白人/高加索患者中，重型酒精性肝炎患者的比例相似，但在非裔美国人患者中比例较低。结论种族是影响不同亚型ALD患者年龄和病情的主要因素。
BackgroundThe frequency of alcoholic liver disease (ALD), including alcoholic steatosis, hepatitis, and cirrhosis, varies significantly by ethnicity.MethodsWith the goal to assess the role of ethnicity in determining the age of onset and severity of ALD and to compare the risk factors for its progression among ethnic groups, we conducted a retrospective chart review of all patients with ALD who were admitted or were followed as outpatients at University of California Davis Medical Center between 2002 and 2010. After excluding HBsAg- and HIV-positive subjects, we reviewed the charts of 791 patients with ALD including 130 with alcoholic fatty liver, 154 with alcoholic hepatitis, and 507 with alcoholic cirrhosis.ResultsWhen controlling for all variables in the model, Hispanic patients presented at significantly 4 to 10years younger ages than White/Caucasian patients, in each of the 3 disease severity categories, and the results were confirmed after excluding HCV Ab-/RNA-positive subjects. There were more obese Hispanic patients than White/Caucasian patients, whereas the proportion of patients with hepatitis C was significantly greater in African American subjects with alcoholic hepatitis, and the proportion of patients with diabetes mellitus was significantly lower in White/Caucasian subjects than in Hispanic subjects with cirrhosis. The proportion of subjects with severe alcoholic hepatitis was similar in Hispanic and White/Caucasian patients, but lower in African American subjects.ConclusionsEthnicity is a major factor affecting the age and severity of presentation of different subtypes of ALD.